| NPI | 1295200079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: FL 19573) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-18-64913) |
| Enumeration Date | 2018-10-09 |
| Last Update Date | 2026-02-24 |